One major problem associated with many minimally invasive endoscopic surgical procedures is the removal of large volumes of tissue through an access sheath. These minimally invasive surgical procedures typically utilize access sheaths having inner diameters ranging in size from 5 mm to 20 mm. Surgical instruments, as well as an endoscope, are inserted through these access sheaths to the surgical site. For example, when surgery is performed within the peritoneal cavity, the cavity is insufflated with a gas to permit viewing of the surgical site as well as provide room in which to manipulate the surgical instruments. As a result, valves or other sealing devices are utilized with these access sheaths to prevent deflation of the peritoneal cavity.
During these minimally invasive endoscopic procedures, it is common that a cyst, tumor, or other affected tissue or organ must be removed through these access sheaths. When the volume of the tissue is small with respect to the access sheath, removal is relatively straightforward. However, when large volumes of tissue must be removed, the use of debulking instruments such as a morcellator are utilized to reduce the size of the tissue by removing small portions thereof through the access sheath. A number of manually operated morcellators are presently available for morcellating or debulking tissue. However, such devices are typically inefficient and require extensive periods of time to remove a large volume of tissue through the access sheath.
Another problem associated with the debulking, removal or morcellation of large tissue volumes is the concern for containing malignant or pathogenic tissue. The morbidity of patients significantly increases when malignant cells of such large volume tissue are permitted to come in contact with surrounding healthy tissue. A malignancy would typically indicate a more invasive procedure in which the cavity is opened and the affected tissue is removed. These invasive open cavity procedures increase the recovery period of the patient and subject the patient to additional discomfort and complications.
As a result, the debulking of large malignant tissue volumes percutaneously through an access sheath presents significant morbidity risks to the patient. Only when other complicating factors are involved is the debulking of large malignant tissue volumes even indicated.